Depression and Health Service Utilization in Physically Disabled Medicaid Fee-for-Service Enrollees

Wieland, Lisa S.

Full Metadata

Overview

Year:: 2008
Contributor:: Wieland, Lisa S. (creator); Allen, Susan (director); Intrator, Orna (reader); Pirraglia, Paul (reader); Dickersin, Kay (reader); Brown University. Division of Biology and Medicine. Epidemiology (sponsor)
Genre:: theses
Subject:: Depression; Health Services; Physical Disability; Depression, Mental; Medical care; Medicaid
Extent:: ic, 96 p.
DOI: https://doi.org/10.7301/Z0J101KD

Files

Description

Abstract:: Background: Although depression is prevalent among working-aged Medicaid enrollees with physical disabilities, the association of depression and health service utilization has not been examined in this population. The relationship between depression and validity of self-reported health service utilization has also not been well explored. Objectives: We tested the hypotheses that depression is associated with both increased non-mental health service utilization and with overreporting of prior health service utilization. Methods: We linked data from a 2001 telephone survey of 556 physically disabled working-age Medicaid enrollees to paid Medicaid claims for the 12 months preceding and following the survey. The association between a claims diagnosis of depression during the previous year or a survey report of depression, and non-mental health emergency department (ED) or hospital utilization was examined for the 12 months following the survey. Self-reports of ED visits, hospitalization and inpatient nights during the previous year were compared to paid claims for the 12 months preceding the survey. Agreement between self-reports and paid claims was compared for respondents who did and did not report recent depressed mood. Results: After adjustment for demographics and physical health, a depression diagnosis was associated with increased odds of a non-mental health ED visit (OR=2.28, 95% CI = 1.22, 4.26). There was no increase in the odds of hospitalization. Survey respondents reported more ED and hospital utilization than was contained in paid Medicaid claims. After adjustment for demographics and factors associated with reporting error, recent depressed mood increased overreports of ED visits by 37% and was associated with overreporting inpatient nights by 1-7 nights. Conclusion: In working-aged adults with disabilities, depression is associated with increased non-mental health ED use. However, recent depressed mood is associated with greater overreporting of previous ED and hospital utilization. Further research is needed to assess whether depression may be a modifiable factor in efforts to reduce non-mental health utilization in this population. In the meantime, self-reports of health service use should be used with caution when assessing the relationship between depression and health service utilization.
Notes:: Thesis (Ph.D.) -- Brown University (2009)

Content

Access Conditions

Rights: In Copyright
Restrictions on Use: Collection is open for research.

Citation

Wieland, Lisa S., "Depression and Health Service Utilization in Physically Disabled Medicaid Fee-for-Service Enrollees" (2008). Epidemiology Theses and Dissertations, Biology and Medicine Theses and Dissertations. Brown Digital Repository. Brown University Library. https://doi.org/10.7301/Z0J101KD

Relations

Collections:

Epidemiology Theses and Dissertations

Theses and Dissertations for the Epidemiology department.
...
Biology and Medicine Theses and Dissertations

Theses and Dissertations for the Biology and Medicine department.
...